Key result
Postintubation hypotension was associated with significantly higher mortality compared to patients who did not develop the condition (33.2% vs 19.6%, P<0.001).
Why the study?
Hypovolemic patients can develop postintubation hypotension, motivating a review of the literature regarding postintubation hypotension and its association with mortality.
Does post-intubation hypotension increase mortality in intubated patients?
Meta-Analysis (n=2,044)
Does post-intubation hypotension increase mortality in intubated patients?
Absolute Event Rate: 33.2% vs 19.6%
p-value: p=<0.001
Post-intubation hypotension is associated with significantly increased mortality, highlighting the importance of targeted resuscitation in hypovolemic patients prior to intubation.
PIH was associated with higher mortality in hypovolemic patients; extends observational data but leaves open whether pre-intubation resuscitation alters outcomes.
Hypovolemic patients can develop postintubation hypotension (PIH). Our objective is to review the literature regarding PIH and the association with mortality. We searched MEDLINE from inception to February 2018. A meta-analysis was performed to assess the effect of PIH on mortality. The results of the meta-analysis were reported in forest plots of the estimated effects of the included studies with a 95 per cent confidence interval. Heterogeneity was evaluated using the I 2 test, which corresponded to low (I 2 < 25%), medium (I 2 = 25–75%), and high (I 2 > 75%) heterogeneity. We identified 243 records. Four studies were included in the meta-analysis. The studies reported 2044 patients with 36.8 per cent (n = 753) developing PIH. Data indirectly reflecting the hemodynamic status were available in three studies (n = 1117 patients). Overall mortality was 24.6 per cent (n = 503) and was significantly higher in patients that developed PIH [mortality, n (%): PIH = 250/753 (33.2%) vs 253/1291 (19.6%), P < 0.001]. Patients that develop PIH have an increased mortality. Considering a targeted resuscitation in hypovolemic patients is pivotal to minimize PIH.
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Ferrada et al. (2019) conducted a meta-analysis in Postintubation hypotension in hypovolemic patients (n=2,044). Postintubation hypotension vs. No postintubation hypotension was evaluated on Mortality (p=<0.001). Postintubation hypotension was associated with significantly higher mortality compared to patients who did not develop the condition (33.2% vs 19.6%, P<0.001).
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